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目的:回顾性研究外伤性颅内血肿致脑疝患者的救治经验,探讨手术为主的外科综合治疗措施,以改善患者的预后。方法:分析108例外伤性颅内血肿致脑疝患者的颅内血肿类型、临床特征、抢救措施、手术方式及预后状况。结果:全组67例GCS3分~5分,41例GCS6分~8分。GOS预后:恢复良好28例(25.93%),中残10例(9.26%),重残18例(16.67%),植物生存6例(5.56%),死亡38例(35.19%)。结论:早期诊断和及时手术减压、标准外伤大骨瓣减压术、亚低温治疗、高压氧治疗、颅内压监护、血浆渗透压监测、加强术后的监护和防治并发症,是提高外伤性颅内血肿致脑疝患者救治成功率和改善其生存质量的重要手段。
OBJECTIVE: To retrospectively study the experience of treatment of traumatic intracranial hematoma caused by brain herniation and explore surgical comprehensive treatment measures based on surgery to improve the prognosis of patients. Methods: The types, clinical features, rescue measures, operation methods and prognosis of 108 patients with intracerebral hemorrhage due to traumatic intracranial hematoma were analyzed. Results: The whole group of 67 cases of GCS3 points ~ 5 points, 41 cases of GCS6 points ~ 8 points. GOS prognosis: 28 cases (25.93%) recovered well, 10 cases (9.26%) had moderate disability, 18 cases (16.67%) had severe disability, 6 cases (5.56%) had plant survival and 38 (35.19%) died. Conclusion: Early diagnosis and timely surgical decompression, standard trauma and cataract decompression, mild hypothermia therapy, hyperbaric oxygen therapy, intracranial pressure monitoring, monitoring of plasma osmolality, postoperative care and prevention and treatment complications, is to improve trauma Sexual intracranial hematoma in patients with brain herniation success rate and improve the quality of life an important means.